United Kingdom Homecare Association Ltd is the professional association of home care providers from the independent, voluntary, not-for-profit and statutory sectors

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The social care system is in danger of failing older and disabled people who are dependent on the vital support that homecare services deliver. This week’s Guardian survey* highlights serious problems with the way homecare services in England are funded by local councils.

UKHCA has repeatedly warned that older and disabled people have had to console themselves with receiving council-funded services of increasingly short homecare visits which struggle to meet their basic needs.

The survey clearly shows that the most important concerns of people who use homecare services and their families is that there must be enough time available for friendly, respectful and capable care workers to provide safe care in the home.

Homecare providers are very concerned that they are often prevented from delivering services with sufficient time or flexibility to meet the choices and preferences of service users, because of rigid and constraining contracts from local councils.

UKHCA has expressed concern over the discrepancy between the quality of services that councils wish to purchase and the price they are prepared to pay. It is time to look seriously at how we can create a better system for care, based on a realistic assessment of costs.

UKHCA is keen to work with local councils to make real improvements in the commissioning and delivery of homecare services as a matter of urgency. Councils must take responsibility for their commissioning. It is unthinkable that we go on supporting a failing system without any hope of improvement.

People who use homecare services are being let down because of poor funding and an approach to commissioning that cannot address their care needs adequately. This has to change.

The Social Care Commitment was launched yesterday (September 9th) at Skills for Care. The Social Care Commitment is a voluntary agreement, between all parts of all parts of the social care sector in England, about workforce quality. The commitment is made up of seven employer statements and seven employee statements. Its primary purpose is to give adult care and support employers the opportunity to make a public statement that will give the general public confidence that they and their families will always be supported by skilled people who treat them with dignity and respect.

Employer statements

1. I will take account of potential employees’ values, attitudes and behaviours when recruiting new staff.

2. I will provide thorough induction for all new staff and for those changing job roles.

3. I will provide timely, appropriate and accessible education, learning and development opportunities to enable my employees to develop and strengthen their skills and knowledge.

4. I will encourage everyone I employ to sign up to the Social Care Commitment and to commit to any codes, standards or registration systems applicable to their job role.

5. I will take responsibility for the values, attitudes and behaviours that my employees display at work, including upholding and promoting equality, diversity and inclusion.

6. I will regularly monitor the skills and behaviour of everyone I employ, ensuring that feedback is encouraged from anyone they support or have direct contact with, including families and carers.

7. I will work to ensure a positive culture and working environment where all employees are supported to do what they’ve said they will as part of their Social Care Commitment.

Employee statements

1. I will always take responsibility for the things I do or don’t do.

2. I will always promote and uphold the privacy, dignity, rights, health and wellbeing of people who need care and support.

3. I will work co-operatively with others to ensure the delivery of safe, high-quality care and support.

4. I will communicate in an effective way to promote the wellbeing of people who need care and support.

5. I will respect people’s right to confidentiality, protecting and upholding their privacy and dignity.

6. I will improve the quality of the care and support I provide by constantly reflecting on and updating my own knowledge, skills and experience.

7. I will promote equality, diversity and inclusion by treating all people fairly and without bias.

The commitment is based on the Code of Conduct, which sets out what is expected of adult social care workers. Making the commitment tells colleagues, employers and, most importantly, people who need care and support that the standards in the Code of Conduct will be put into practice.

To sign-up, employers have to commit to the seven statements and select the actions they will take to meet each statement. An Organisational Development Plan will then be produced to download, and access given to resources to help the employer achieve the actions.

Once employers have signed up they can encourage their employees to make the commitment, to ensure their whole workforce is working together to deliver quality care and support.

The launch today at Skills for Care was a ‘soft’ launch to invited guests, including UKHCA. There will be a final launch in December by a government minister. However, The Social Care Commitment is up and running from today and employers can commit by going to The Social Care Commitment website: https://www.thesocialcarecommitment.org.uk/

Speaking at the launch, Glen Mason said that social care employers making the commitment will gain a competitive advantage over those employers who don’t. Employers will gain access to a range of resources from across the sector to help with workforce development. Signing up proves employers’ commitment and dedication to improving care and support, and promotes their organisations publicly as a quality provider of services. Once employers sign-up, they can use The Social Care Commitment logo on their publicity.

Signing-up will also help improve recruitment and retention. Future workers will know they are joining an employers committed to delivering high quality services and existing employees know that they are with an employer who will invest in their development.

UKHCA would encourage all our member organisations in England to make The Social Care Commitment.

On Tuesday, 20th August, UKHCA attended a round-table event on the use of zero-hours contracts of employment across all employment sectors, at the invitation of Shadow Business Secretary, Chuka Umunna MP. The event was attended by representatives of employers, employees, academics and MPs.

The UK homecare sector contains a workforce of at least 490,000 employees, working through 9,000 registered homecare agencies and similar organisations (including local authority in-house teams). The vast majority (estimate up to 70%) of homecare is purchased by local councils (and Health and Social Care Trusts in Northern Ireland), but delivered by independent and voluntary sector organisations under a variety of contract arrangements.

Our comments relate to statutory sector purchase of homecare delivered by a workforce employed in the independent and voluntary sector.

UKHCA member organisations had responded generously with comments, views and experiences on the subject of zero-hours contracts in response to our preparation for this meeting.

The use of zero-hours contracts in the independent and voluntary homecare sector is extensive and longstanding. There is no consistent dataset across the UK, nor is there a single definition of what constitutes a zero-hours contract. Estimating the precise extent of zero-hours contracts is therefore problematic. Our estimate is that at least 50% of the homecare workforce are employed on these contracts, and probably significantly higher.

However, the working patterns of homecare workers are vastly different from other sectors and the way that zero-hours employment has been explained to the public in recent media reporting has been unclear.

Demand for homecare services vary throughout the day, typically peeking around early morning, lunchtimes and evenings. Generally, careworkers will provide support for several people each week on an ongoing basis. Over time, their working patterns will vary as their service users regain independence, require more care, are admitted into hospital or enter residential care.

Zero-hours contracts enable flexible working patterns which respond to demand and the needs of individual service users. While this can create a degree of unpredictability of working patterns (and therefore wages), it is rare that careworkers face the commonly reported stop-start working described in other employment sectors by the Media.

However, we must be clear that the use of zero-hours contracts is largely determined by local authorities, who buy the majority of care delivered by the independent and voluntary sector.

Councils themselves almost universally purchase care according to the time that workers are in a service user’s home (we refer to this as “contact time”). From the fees generated the provider must pay their workers (including applicable travel time for National Minimum Wage purposes) and the costs of their operation (including training, supervision, and management costs).

In UKHCA’s 2012 Commissioning Survey, “Care is not a Commodity”, we found very little evidence of councils calculating fees paid to providers by any other method than contact time (See: http://www.ukhca.co.uk/downloads.aspx?ID=356). In addition, historically providers have faced contracts from councils, typically of three year periods, where there was a high risk of non-renewal at the end of the contract period, or where there was no guarantee of purchase during the life of contract.

While recent Media reporting has suggested a significant increase in the use of zero-hours contracts across the UK, we do not believe that there has been a recent expansion in the homecare sector, above levels already being used.

However, we are absolutely clear that the current commissioning of homecare services by local authorities, facing massive public spending constraints, makes the use of zero-hours absolutely essential for the functioning of the homecare sector at the level we have already achieved.

The policy direction in all four UK administrations places homecare services at the forefront of services for people using social care. It is essential that our sector is able to expand. This will inevitably be with the continued use of zero-hours contracts.

The sector has faced two additional issues which support the inevitable use of zero-hours contracts:

1) Aggressive price cuts by councils: We estimate that 90% of providers experienced a real-terms decrease in fees paid by the councils with which they trade in the financial year 2011-12 alone, with no realistic prospect of better terms in the next few years; and

2) An increasing appetite by central and local government for plurality of providers in the market as part of the personalisation agenda, reducing the number of contracts with any guaranteed purchase by councils, the introduction of “framework agreements” open to multiple providers, and an increasing use of personal budgets and direct payments.

The objectives of personal choice for people who use services and a diverse market of providers are both widely supported. However, it must be understood that both of these factors increase the likelihood of a workforce which does not reach optimum “economic efficiency”, as there is considerable unpredictability of work, especially where councils choose to put packages of care out to multiple providers and initiate competitive bidding (usually based on price).

In the many responses UKHCA has received from homecare providers there is a clear message that the homecare sector, and individual businesses would not be able to operate without extensive use of zero-hours contracts. A number of responses from providers indicated that if zero-hours contracts were effectively “banned”, their businesses would face closure.

The ability to pay workers for periods of inactivity during the day, including where ongoing work with an individual service user ceases for the variety of reasons described above is, in our view, economically unviable for all but a limited number of homecare providers. Media portrayals of the increasing use of zero-hours contracts have included references to a shift of risk from employer to worker. It is our view that in the homecare sector there is actually a passing of the risks faced by local government which is shared between both provider (in terms of predictable revenue) and worker (in terms of predictable wages).

It is also clear from our member organisations that the use of zero-hours contracts in our sector does not match the Media portrayal of other employment sectors where these contracts are used.

Many providers continue to report the widespread attraction of flexible working for our workforce, and the number of workers who combine homecare services with personal commitments, including childcare and variable income requirements over time. Employers were also clear that it was in their interests to ensure that their workforce understood the terms and conditions of their working arrangements, and how they could make changes in their availability and desired number of hours known.

Providers have repeatedly stated that as their income is generated almost entirely on the hours of care they deliver, they have every incentive to ensure that their workers receive as many opportunities to obtain as much work as they are willing to accept. Even those few employers who operate both guaranteed hours contracts and zero-hours contracts reported a significant proportion of their workforce who opted for zero-hours arrangements.

In conclusion, UKHCA maintains that the ethical use of zero-hours contracts in the homecare sector is both inevitable (because of the operating environment) and meets a demand from a workforce who themselves benefit from the flexibility it offers.

Calls for a reduction in zero-hours contracts within our sector would require a massive increase in the spend on social care by local authorities which we believe is entirely unachievable in the current economic climate, and with the regrettably low status that society places on social care work and care services which the state purchases on behalf of older and disabled people.

The Rule does not, however, prevent individual organisations from explaining the points that they made outside the meeting. This article therefore summarises and expands on the essence of the information which UKHCA provided to delegates.

Our impression of the meeting was that there was widespread acknowledgement among delegates that use of zero-hours contracts in the homecare sector is the result of the way that homecare services are commissioned by local authorities.

UKHCA is grateful to Chuka Umunna MP and the Labour Party Business Team for the opportunity to participate in the round-table.

Today is the deadline for responses to CQC’s consultation, ‘A new start’. This is the first in a series of consultations and discussions since they issued their strategy in early 2013.

There are a number of proposals in the consultation that providers will be able to welcome, such as:

The move from a compliance only inspector to one that looks for and recognises high quality, innovative care.
The move from general to specialist inspectors.
The introduction of a new ratings system.

Whilst these proposals are welcomed, there are a number of issues with the plans, primarily due to the fact that they seem to have been designed with a health focus making them difficult to interpret for homecare. We have sent in our full response today which outlines our concerns and suggestions for improvement.

We look forward to working with our members and CQC on the future consultations, creating a regulatory system that works for everyone.

Yesterday our Chief Executive, Bridget Warr signed a partnership agreement with Mark Hoban, Minister of State for Employment, which sets out ways in which we will work together. At the heart of the agreement is a desire to encourage more of the right people to consider a career in homecare by making sure Job Centre plus staff are well informed about what working in homecare is all about and making links with local UKHCA members.

We’ll also be able to tell DWP about the recruitment needs of our sector and what local schemes and practices work best so they can be rolled out to other areas.

This is the start of what we hope will be a long and fruitful relationship.

We are delighted to announce that the UKHCA Costing Model is now free and available to everyone from our website. This easy to use, web-based tool has been specifically created to help homecare providers build a comprehensive view of the costs involved in delivering high quality homecare.

Developed by finance directors and tested by UKHCA members, the Costing Model aims to showcase the real and full cost of delivering care in the home. We believe this will prove to be a vital tool to both homecare providers and Local Authority commissioning bodies. Previously available exclusively to UKHCA members, we have made the model freely available in order to develop a wider appreciation throughout the sector of the variety and extent of costs associated with the delivery of high quality care. It also provides a platform for an open, transparent relationship between providers and commissioners.

On Tuesday April 30th, the UKHCA Policy team attended the Naidex National Event, held at the NEC Birmingham. Running across three days, Naidex had an impressive array of presentations and exhibitors that catered for all interests across the health and social care spectrum.

The vast hall buzzed with curiosity and enthusiasm from traders, professionals and members of the public, as hundreds of stalls demonstrated an array of new technologies and crowds gathered to hear industry leaders provide an insight into the latest developments.

Speakers included UKHCA President Lucianne Sawyer, who spoke about ‘coping with the future demand’ of social care, and what can be done to enhance the reputation of social care as a career. Lucianne called for change that would allow workers to be freed up to take the initiative with their work. Furthermore a closer focus on outcomes would help to make domiciliary care jobs more appealing and satisfying, increasing applicants and staff retention rates.

Skills for Care Chief Executive Sharon Allen continued Lucianne’s theme, through a workshop on attracting and retaining ‘the perfect workforce.’ Ms Allen highlighted the need for investment in the development of the workforce, investment that would be reflected and rewarded through greater skills, competence and confidence of workers. With as many as an extra million care workers needed by 2025, it is vital that the social care sector makes better use of a range of media/social media platforms to advertise opportunities and appeal to as many people as possible. To help let potential new workers make informed choices, Skills for Care have developed the ‘Career pathways e-tool’, which can be found on their website.

Also present at Naidex were UKHCA members Home Instead Senior Care. In addition to a talk from Managing Director (and UKHCA Board member) Trevor Brocklebank on revolutionising domiciliary care, Home Instead were a visible presence at Naidex thanks to the launch of their new film with ITN Productions. Shown on screens around the building throughout the three day event, the film shows Home Instead’s unique approach to care of the elderly and their role in providing clients living with dementia the chance to live independently for as long as possible.
• Information on the film can be found on the Home Instead website or click here to watch it.

Chief Executive of ECCA, Martin Green, explored methods for coping with budget cuts. “Budget based procurement” necessitates that care and support providers think creatively when responding to challenges, with Martin suggesting that diversified business models and closer partnerships between charities/private organisations/social enterprises would help the sector deliver more even with less funding.

The Chair’s Special Policy Lead of CQC, Alan Rosenbach, focused on the new CQC strategy. The three year plan includes;
• Increased specialisation of inspectors (including a Chief Inspector of Social Care)
• Intention to make better use of information and data, to identify providers with problems.
• A plan to identify more people at corporate level that will be held responsible for levels of quality.
• A tougher system of registration with CQC
• An academy to be set up within CQC to appropriately train staff.

Naidex Scotland is taking place on 18th-19th September, with Naidex National 2014 already planned for 29th April-1st May 2014.